Just Say No…to Overworking Yourself

Jennifer Frank, MD


October 27, 2021

I am a part of a group of physician leaders who get together to discuss the challenges of being clinical leaders and support each other. Recently, we started reading the book Essentialism, by Greg McKeown. Recently, a colleague asked how he can say no, considering that he is not fully in charge of his work or his schedule. This is one of the most common questions I get from other leaders. Despite not fully mastering this art myself, I have had to learn how to say no in order to have any semblance of work-life balance.

Saying no more easily can actually start with saying yes. If the request is coming from your boss or is one you just aren't comfortable saying no to, it can be a good idea to say yes, with a "but" attached.

Yes, I can pick up that shift this weekend, but I will need to take off one day next week.

Yes, I would be happy to take on that new project, but I will need to hit pause on another project to make room in my schedule to do it well.

Yes, I'm able to see an extra patient today, but it will need to be at the end of the day because I don't want to keep my scheduled patients waiting.

I have found the "yes, but" strategy very effective. I also use this with patients, as it tends to disarm whoever you are talking to and indicate an openness and willingness that makes them more receptive to what you say after the "but."

Yes, I will send in that antibiotic for you, but not for another few days since most sinus infections don't require antibiotics in the first week.

Yes, I will order that lab test for you, but I am concerned that it may not help us figure out what is going on and may not be covered by your insurance.

Another approach I use is the preemptive strike. I will define my limits in advance of requests so that my no is tied into a principle I've already embraced rather than a specific request. In my role as a physician leader, I am frequently invited to meetings — early morning, evening, and even during my scheduled clinic. I decide what I am willing or able to do in the context of any request I may receive.

I'm not able to make that meeting on Monday because I am scheduled in clinic and do not reschedule patients except in an emergency.

I'm only able to attend one evening meeting a week, and I'm already scheduled this week.

The earliest I'm able to meet is 7 AM. I'd be happy to meet at 7 or on a different day.

Another approach that has worked well for me is the counteroffer. This signals a no but allows you to meet the requestor halfway, which is a universal indication of good faith and willingness to compromise.

I'm not able to attend the meeting, but I would be happy to review the minutes afterward or hop on a quick call to find out what I missed.

I'm not able to refill your benzodiazepine prescription early, but I have some ideas on other approaches that may help you with your anxiety.

Saying no is hard for everyone because we don't want to disappoint or be viewed as difficult. However, saying no is essential for work-life balance and to preserve room for what is most important. Fortunately, there are many ways to say no.

How have you managed to say no gracefully? Please share your own wisdom and experience in navigating this fine line.

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About Dr Jennifer Frank
Jennifer Frank has the unbelievable privilege of being a family physician, physician leader, wife, and mother in Northeast Wisconsin. When it comes to balancing work and life, she is her own worst enemy because she loves to be busy and enjoys many different things. In her spare time (ha!), she enjoys reading suspense and murder mysteries as well as books on leadership and self-improvement. She also writes her own murder mysteries and loves being outdoors.
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